BON VOYAGE, MY DEAR PATIENT!

Alex came to see me six years ago. She was at a very low point in her life. Nothing seemed to work for her then. She was depressed and had so much anxiety that she was contemplating suicide just to be at peace, to get a break from the storm of thoughts and feelings swirling constantly through her mind. She has come a long way since. She has gone through many trials and succeeded in keeping her cool and getting stronger as she went. She grew as an artist and became much more accomplished, expanding her skills, exploring new frontiers of her creativity.
She had to use medication to stabilize her mood, but we managed to find a good combination (Pristiq and Seroquel) that helped her without side effects and without stifling her creativity. But career wise, she was still struggling. Los Angeles doesn’t seem to offer her the chance she needs to be financially stable, enough to not have to worry every month about where the money for the rent is going to come from. She was born and raised in Chicago. She feels Los Angeles is her home. Yet there are better work opportunities for her back in Chicago.
A few months ago, when she first began to consider moving back to Chicago, together we looked carefully at all the alternatives she had and decided that moving back there was the sensible thing for her to do. She then started planning and she did an excellent job sorting things out and reorganizing her life for the big move. Time flying the way it usually does, it took us both by surprise to realize last week that it’s time for her to actually go. We had our last face to face session last week. She will fly to Chicago on Christmas Eve—it’s final.
It was a very emotional last session. I felt like a parent who sends his favorite child to college, knowing that the best thing to do is to let her go, yet having an immense urge to keep her home, to protect her from any harm that may come.
We went again over all the details of the plan and the immediate steps she needed to take once she gets to Chicago. We talked about her having the right clothes, gloves, boots, scarves, heavy jacket, for the winter there. We talked about how Daisy, the cute poodle/terrier mix Alex rescued at my suggestion after seeing her consumed by loneliness, will look with her new boots and her new, colorful sweater that will help her fend off the cold she is not used to. While we were talking, Daisy was gamboling on the floor, chewing happily on her rawhide bone treat I gave her and waving her tail in a very good mood. Since the rescue, she has been fully trained as a companion dog. Armed with the letter I had written, stating that Daisy is not just a dog but an emotional companion, Alex could take Daisy, who rapidly became inseparable from her, everywhere she went, to stores and restaurants, buses and planes, places otherwise inaccessible to a dog.
Because Alex will have a period of transition of at least one or two months in her medical care, I gave her as many medication samples as I could to bridge her over. As I am not licensed in the state of Illinois, she will have to see a psychiatrist there and I gave her a letter for her future doctor with a summary of her medical history. We scheduled our future bimonthly phone sessions for the coming months. Through all this process, Alex has been a very good sport. She kept her focus on managing the move. She kept her emotions steady. She did everything she could to ensure a smooth transition.
But good-byes are never easy. In the end, not knowing what more I could do for her I hugged her. It was time to go and she knew it. She has to take her chances where her best opportunities are. She was apprehensive, of course. She knew I was worried about her too. But, very bravely, she knew she was ready.
At the end of the six years of working together, she now had the strength to move to the next level in her life. And she is moving on like a winner--strong, in control of her fears and with a confident smile on her face. A successful intervention, I could say. Another patient becoming “better than cured.” Yet for me it was sad to part with her. I will not be able to help her as much in Chicago as I did while she was living in Los Angeles. I have to trust she will find a good psychiatrist there and that her mood will withstand the challenges she will have to face. I have to trust that I have prepared her well for these challenges and that, in the end, she will become more fulfilled. I know I will miss her smile and her engaging, creative energy. I will miss being part of her successes as I have been fortunate enough to be until now, and I will miss being at her side when she has a setback.
But I know she will do well.
Cody-Kundalini, my red tabby cat, staring dreamely at the Christmas tree, reminds me it’s nearly Christmas and life will go on. It’s holiday season and there is much to celebrate. Soon we’ll begin a new year, with new promises and new hopes. A new beginning for all.